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NPI Code Detail

MEDICARE: EVAN NIAKAMAL

MEDICARE: EVAN NIAKAMAL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant

General Provider Information

NPI Number : 1639796873
Entity Type Code : Individual
Provider Name (Legal Business Name) : EVAN NIAKAMAL
Provider Business Mailing Address
First Line : 16 CALLE ALIMAR
Second Line :
City : RANCHO SANTA MARGARITA
State : CA
Zip : 92688-2318
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 488 E VALLEY PKWY STE 311
Second Line :
City : ESCONDIDO
State : CA
Zip : 92025-3374
Country : US
Telephone Number : 760-520-8340
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/04/2020
Last Update Date : 03/06/2026

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Directions to “ EVAN NIAKAMAL ” Practice Location

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